Pituitary Adenoma is a tumor on the pituitary gland. The pituitary gland is an endocrine gland that is about the size of a small bean. This gland (also referred to as the hypophysis) is located at the base of the brain. The pituitary gland produces and releases hormones that regulate homeostasis and stimulate other endocrine glands. It has two lobes called an anterior and a posterior. The posterior lobe releases oxytocin and anti-diuretic hormone known as vasopressin. The anterior lobe produces (among others) these hormones: prolactin, follicle stimulating hormone, luteinizing hormone, thyroid stimulating hormone, prolactin, and endorphins.
Pituitary adenomas are identified in up to 10% of all intracranial neoplasms. Neoplasm is another word for tumor. These tumors can remain undiagnosed and can be found in up to 24% of adults during autopsy.
Pituitary adenomas can cause certain diseases. The symptoms are related to the disease being caused.
Prolatinoma and other nonfunctioning pituitary adenoma have these symptoms: absence of menstruation, infertility, unexplained breast milk production, impotence, vaginal dryness, vision loss, oligomenorrhea – sparse or irregular menstruation and infertility.
Acromegaly is caused by a growth hormone secreting adenoma. Symptoms for acromegaly are hand, foot, face and tongue enlargement or growth, sleep apnea, ring or shoe size growth, facial paralysis, achy joints and impotence.
Thyrotropin secreting adenomas cause weight loss, increased appetite, tachycardia, tremors, frequent bowel movements, decreased menstrual flow, shortness of breath, heat intolerance, increased sweating, vision changes, eye irritation, sudden paralysis and impaired fertility.
Cushing’s Disease is caused by pituitary adenomas that secret ACTH. The symptoms are backache, thin skin, flushed face, weak and fragile muscles and bones, wrinkles and stretch marks, excessive hair growth, mood swings, osteoporosis of the rib and vertebrae, hyperglycemia/diabetes, fat build up in the face, back, and chest.
All pituitary tumors can have these symptoms: growth failure, nausea, dry skin, low or high blood pressure, fatigue, headache, impaired libido, excessive thirst, frequent urination, cold intolerance, unusual, excessive perspiration and menstrual disorders.
Tumor size is defined as macro-adenoma (tumor > 10 mm) or micro-adenoma (tumor < 10 mm).
Visual changes or difficulties and physical symptoms of excessive hormone production are indicative of pursuing a diagnosis of Pituitary Adenoma. Tumors that cause visual difficulties are usually pressing on the optic nerve.
A prolactinoma is the most common secreting pituitary tumor. It is responsible for galactorrhea, hpogonadism, amenorrhea, infertility and impotence. GH-secreting (growth hormone) tumors cause acromegaly. Corticotrophic secreting hormones cause Cushing’s disease. some tumors secrete more than one hormone. Prolactinomas are most commonly diagnosed in pregnant women.
Diagnosis pituitary adenomas can via hormone levels in the blood, MRI scan, venous blood sampling and biopsy. A venous blood sample involves guiding catheters through a small incision in the groin veins up to the petrosal sinuses. Petrosal sinuses are two small veins on the each side of the gland. A hormone, corticotrophin releasing hormone (CRH) is released. Blood samples are then taken from each arem and tested for ACTH secretions.
A biopsy provides unequivocal diagnosis of a pituitary adenoma. Most biochemical tests are accurate and some adenomas can be treated with radiation therapy, medication and surgery.
Treatment for these adenomas depends on size, type, if it has spread into the brain, health and age of the patient. Three treatment options are used either singularly or in combination: radiation, surgery and drugs.
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